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The Office of Epidemiology in the New Mexico Department of Health and the University of New Mexico Health Sciences Center Program in Occupational and Environmental Health have established an occupational illness, toxic exposure and injury surveillance program in the State of New Mexico. Data from New Mexico Vital Records and Health Statistics and the Census of Fatal Occupational Injury has revealed a fatality rate of 4.4-7.6 deaths per 100,000 employed persons aged 16 years and older that is higher than the U.S. mortality rate of 4.0-4.6 deaths for the years 1998-2002. Analysis of the causes and distribution of the deaths was conducted. Findings showed that occupational fatality rates were highest in rural counties, and that 15.60/0 of workers worked in industries and occupations at high risk for occupational mortality, compared with 6.6% nationally in 2000. Additionally, differences in gender, race/ethnicity, and employment status were observed for occupational fatalities. The underlying factors for occupational injury mortality will be discussed. Partnership with the health care community is critical to the success of an occupational health registry. Therefore, the second part of the presentation will discuss the New Mexico Occupational Health Surveillance Project and the New Mexico Occupational Health Registry, including purpose and objectives, statutory authority for establishing a registry and a discussion on how to submit a report.